tv [untitled] CSPAN June 28, 2009 12:30pm-1:00pm EDT
instead of keeping it as a permanent slush fund for treasury, let's get every american insured. once every american has a health insurance policy, the cost of health care and health insurance will go down dramatically. it's going to go the opposite way if the government runs it. >> the plan that we have, and actually the plan that's been put on the table by ryan and nunez, is budget-neutral. doesn't cost any more money over a period of time. if we as a society reform our health system in a positive way, in a way that provides the appropriate incentives in the system and allows for the appropriate connotation and the appropriate decision-making authority for patients and their families, then you save extraordinary amounts of money. so, again, this sense that you've got to have another trillion dollars spent by the federal government in order to save the health system, it is just simply not true.
>> just continuing with that point, first, can you talk a bit about whether the way that the tarp language was initially written, it would allow you to say that it's terminated after five years or would, you know -- would banks say that, no, we didn't originally agree to this when we accepted the tarp money. and also, what's the way to finance it once the $700 billion tarp money runs out after 10 years or however long? >> which means they supposedly came to issue money. but they have basically changed the law since we passed it. i believe that it will continue to be a 700 trillion dollars slush fund for treasury if we don't take that money back.
my question is what happens to it when it comes back. he says it comes back, we can reissue it. has not agreed as far as i know to sunset that. after 10 years, we just have to see where we're going. the point here is i believe you get everyone insured, you make information more transparent, the cost of health insurance is going to stabilize and probably fall if we allow it to be a competitive market. the thing to compare it with, though, is the multitrillions of dollars that a government takeover is going to cost us, if we go the president's way. >> question here? >> yesterday the president also said that as far as the government sponsored solution crowding out the private solutions, he said that would suggest that the government solution is doing something right.
would you like to speak to that? >> it simply isn't the case. it's just not true what he says. the reason that a government plan would -- that individuals would flock to a government plan is because they game the system. you can't have a level playing field. the question i asked yesterday in committee, are these plans going to be paying local taxes, state taxes, federal taxes? answer no. well, if not, then aren't they -- isn't that a subsidy for the government plan itself? well, sure, it is. you're not comparing apples and on,s. employers across this land, because of the regulatory environment, again, in answer to the other question, because of the regulatory environment, if employers across this nation had an opportunity to saying get me out from underneath this incredible onerous burden than the federal government puts on me just because i'm trying to
provide health insurance, health coverage for my employees, please get me out from under it, and there's a ready alternative that washington is running, then tell me what employer in his or her right mind would say, oh, no, i don't want to do that. take that head ache off my plate. it's phenomenal. it's just fantasy. to believe that the federal government won't crowd out private industry and end private health insurance as we know it. >> i'll answer this in just one final thaufplgt i know we need to move obviously but i had a car company in my office the other day. we had not -- it was not currently owned by the federal government. [laughter] they said, ok, gmac has received $10 billion and they're offering five-year, no-interest loans to buy their cars. how can we compete with that without government money? is the government crowding them out? you're darn right they are. what's going to happen with a
government plan? first of all, they won't pay doctors enough to meet their costs. so doctors have to charge private insurers more. someone who's getting their health care to an employer can probably pay less with the government plan because of subsidized taxpayers. so you'll begin to see private policies dry up as small employers say i don't want to do this, go get your health care from the government. it will definitely replace private policies because the government will subsidize those policies. they won't pay doctors enough. there will be more call shifting instead of less. i just have to go back to what is apparently true. this administration believes the american people are stupid. they'll sit there, they'll say while we're reporting 1.9 million jobs lost and say with a straight face, we have saved or created 150,000 jobs. they think we're stupid. they think you don't know that
government does not work well, that the same people who cleaned up after katrina are the ones who can really run your health care system with that personal touch that we all want. they do. they think you're stupid and they think you're not paying attention. they think the media is stupid and won't report this. the fact is, if you look at the uninsured, it's being exaggerated to exaggerate a crisis. again, you've got a lot of folks and noncitizens, those who could sign up for government programs who haven't. you could get that number to 20 or at the most 25. to get those people insured with private policies is a fraction of the cost of the government takeover. we can win this if we engage the american people. they are not stupid. they are alarmed at what this government is doing. they are ready to stand up and speak out, if we give them a plan to get behind. we need to stop a government takeover, we need to get every american insured so every american has access to health care. thank you. [applause]
>> thank you for those presentations on legislation. i'm going to call on the panelists here to talk about various aspects of reforming health care and the debate over reforming health care. if i could ask mr. motley to come up first, the communication director of the -- to discuss how the media has been covering this debate. >> i want to thank you, grover, and everybody at a.t.r. brian manties. i want to thank abc news. because without them, having an all-day love fest for government medicine, we wouldn't have had the idea to do this. it's sad that it's necessary that we have to do this here and it's not a part of the abc news presentation today. they're doing four hours of on-air coverage from the white house to quote unquote moderate
a conversation. you don't moderate a conversation. you moderate a debate. and they don't have the other side. so we thought we'd offer it up for them. david weston yesterday, in response to the media fairness to ligs, which is lamar smith's project in the house, responded by saying we've been giving fair coverage on the health care crisis for years. the first thing to point out, if you're calling it a cry circumstances you're not giving it fair coverpbing. second of all, if he's been doing it for years, let's take january 20 to june 19 of this year, there have been 55 obama -- obama himself or 55 proponents of obama medicine on the air on abc and health care stories versus 18 offering free market or alternatives to what they're proposing with the government takeover. so as we go into this day, and, again, we don't want to preemptively say it's going to be terrible on this, but as abc does its four hours of live
coverage from the white house, with that track record going into their coverage of this today, it leaves you wondering what they're going to do today. i think we all have an inkling. i want to thank everybody, and thank you, grover, for having us. >> thank you. i'd like to call up douglas holts eken to talk about some of the numbers. just briefly, we've been talking for years about billions. some of you may have noticed that the conversation has moved to trillions. so i guess if you could enunciate clearly because sometimes they don't quite make it clear that we've shifted about a thousand times bigger when we move from billions to trillions. what are the numbers? >> i want to thank everyone for the chance to be here today. like many people at this panel, i have some history in this. i recently wrote a paper for the manhattan institute, which was a road map to genuine
bipartisan health care reform, something very different than what we're seeing so far in the congress. before that, i had the privilege and the service of john mccain of engaging in the debate of ideas during a 2008 cycle of what health care should look like going forward in the united states. i did at one time have the great privilege of running the congressional budget office, whose numbers have really become a focal point of this debate, and properly so. the c.b.o. estimate of what the obama budget will do this this country is very striking. it says we are on a path to a dead spiral that will lead to currency crises and national bankruptcy. the health care bills that are coming out are potentially a tipping point in the wrong direction to exactly that path. and so one of the things i wanted to do for those who are not connoisseurs of this little-known agency is talk a little bit about what the congressional budget office does. the answer is these estimates, 1.6 trillion for the senate
finance bill. a number of $1 trillion for the first title of the health bill without even touching the rest of it. these numbers are business as usual for the congressional budget office. its job is to price the federal budget impact of legislation passed by -- or under consideration by the congress. in doing that, there's some things that the c.b.o. does. number one, it scores actual legislation, not ideas. so the debate has moved from the fantasy of what could happen, if you wave your hands, to what will happen if we do what is written in the proposals. second thing it does is it considers all the potential effects. the direct effects of the federal budget. raise tacks, raise spending. and indirect effects. what happens to 1/6 of the u.s. economy that is the health care sector when these proposals are enacted. and importantly, it ranks the options in a very systematic way. it wants to make sure that if even if it's wrong about the overall cost, turns out to be
$1.7 trillion, it can identify more expensive ways to do things, instead of less expensive ways. it does it on a rigorous basis. there are some things it doesn't do. it doesn't respond to lobbying or political pressure. i'm pleased that the senator and the congressman could join us today. i am sure that when i was head of the c.b.o., i disappointed them, but i did so because the agency felt on the intellectual merits we were correct. not on politics or any kind of lobbying influence. doesn't have its own agenda. you're not seeing the c.b.o. agenda. you're seeing a budgetary reflection of what the democrats have proposed. and it certainly is not in the business of saying what is good and bad policy. that in the end will be the job of the u.s. congress. the senators and the congressmen are going to have to decide what is a good and bad way to do business. so far, what we've seen, government plans, higher spending are bad policy.
the budgetary numbers coming from the c.b.o. reflect that, but it will be up to elected officials to move us in a path that centers american health care reform around american families and delivers higheralty care at a lower cost for the american. that is the job we have to focus on next. thank you. [applause] >> thank you, douglas. next speaker is meryl matthews, the director of the council for affordable house insurance. >> well, thank you, grover. it's a great pleasure to be here. i'm here to talk a little bit about the public plan. the government-run public plan, we already have a government-run public plan. it's called medicare and medicaid. it has price controls. everyone is forced into medicare, part a. if you sign up for social security, you have to be in medicare part a. there's a lawsuit out there trying to give people the
freedom to opt out of medicare part a. but currently, you got to be in it. at least that's the way h.h.s. sees it. there's rampant fraud and abuse in medicare and medicaid. whatever the government-run program starts -- however it starts out, it is eventually going to look like medicare and medicaid at some point in time. there will be price controls. one aspect of the legislation, one piece of legislation sfatted that it would be medicare plus 10% for the government-run public option. so they would give doctors and hospitals a little bit more than medicare. maybe. maybe. you may have noticed that congressman wrangle has suggested that he would like to pay for this in part with $400 billion in cuts to medicare and medicaid. the president has suggested a little bit lower number than that, but he included in that $110 billion cut cuts in what they're calling productivity adjustments to doctors and hospitals.
$110 billion in cuts to doctors and hospitals. i'm still waiting to see the headline to say, is this going to hurt seniors? has anybody seen that headline? has anybody seen the press release from aarp saying this will hurt seniors? or is this political? but doesn't the public option give people lower prices? no. it has already been mentioned. the largest act warle firm in the country did a survey of this asking where is the biggest cost shift coming from? from uninsured to the private sector or from medicaid and medicare to the private sector? the biggest cost shift is coming from medicare to the private sector. think about the human being rouse to this. -- the human being riss to this. congress come at it and complain about the cost in the private sector. and yet they're responsible for it. won't there be lower
administrative costs in the public option? no. we had a firm do a study do a few years ago. medicare in the administrative cost. when they talk about the 2% administrative cost in medicare, that's simply what it costs to pay the bills. all the rent on the building, salaries, management, insurance, all of that comes under other parts of the federal budget. and that's what this study did. go through the federal government to find out what those are. even the fraud, the office of inspector general, that comes under a different budget than the medicare administrative costs. medicare administrative costs are actually very high. they may not be quite as high as the private sector, but they are very high and they'll be even higher in the public plan. then there's a start-up cost. if you're going to go out and start up an insurance company, you've got to raise millions of dollars to have in reserves. it's going to ding the taxpayers and claim it's a
savings. in addition, there will be -- if the private sector is actually going to be competitive with the public plan, you'll see members of congress complain about this. we've already seen it twice. in that public plan, medicare, when they created medicare plus choice, they paid the public -- the private sector 95%. congressman pete stark complained that the private sector was siphoning off all the healthy people. that's why he was able to do it for 95%, for 5% less than medicare was doing. when they created medicare advantage, they paid the private sector a little more, about 13% on average. they're complaining about that, that they're overreimbursing them. the administration and congress want to cut those reimbursement rates. the point being, if the private sec for is doing a good job against the public plan, they'll come in and tchange -- change the rules so it didn't do it. it's going to be a rich benefits package. we've already seen that. it's going to make it very
expensive. as a result, health care spending is going to explode. now, because of the public option and the dissatisfaction with it, there's been a sort of a public option like proposal out there called co-ops. maybe we can move to co-ops and find some kind of middle ground. we've already got co-ops out there. there's trade associations that sell health insurance. various kinds of foreign groups and so forth that work as co-ops and provide health insurance. there's a new fascination. we'll make these co-ops non-profit. that will save money. folks, there's a large non-profit and foreign profit sector in health care. there are non-profit hospitals and foreign sector hospitals. i have never seen a study that shows that non-profit hospitals and insurers actually provide lower insurance premiums or lower price services than the foreign profit sector. i have never seen anything that shows that. and if they do create these non-profit co-ops, they will
end up going out as the co-ops do right now and contract with profit insurers to provide the insurance. if you don't do that, you're going to have the federal government that's going to have to ding the taxpayers again to find the reserves for it. so the co-ops are already out there. it's an option, but there's no reason to move to it. they're already there. so is the public plan a good option? well, if you really think the public plan is a good option to keep competition out there and to keep the private sector insurers honest and competitive, why wouldn't you think you need a public option for life insurance to keep the life insurers honest and prices low? why wouldn't you think you would need it for auto insurance? or for food? or for clothing? or for the auto industry? or, in fact, maybe we already do have a public option in the auto industry. and i will bet that toyota will continue to do well even against that. thank you.
[applause] >> we actually have the example of the public alternative in the mail. we have a government-run mail service, the post office. and in order not to have competition underbid them, they have the pass the quotes. so we know how the government reacts to competition to the u.s. postal service. we're now joined by the director of consumers for health care choices. greg? >> thank you, grover, i appreciate it. i'm going to talk about mandatory coverage. i suppose i should start out by confessing that i violated the law on the way here today. the district of columbia has mandated that no one use a cell phone while driving within the district. and i confuse, someone did call me and i did accept it. and i was continuing to drive. in fact, even before i got to
d.c., i was violating another mandate, the 55 marn speed limit along 270 with about 10,000 other people. so the point is that mandates simply don't work. they often talk about -- well, we mandate auto ininsurance coverage, don't we? turns out about 15% of all drivers do not have auto insurance coverage even though it's mandated in 47 states and that's why you have an uninsured motorist rider on your auto policy because it is so broadly violated. all the interest groups in washington support it. the american hospital, the a.m.a., lots of republicans support it along with lots of democrats. but this has happened before. 1988, congress passed a medicare catastrophic program, which required elderly people to buy catastrophic coverage to
supplement their medicare program. it was supported by aarp and the hospitals and the republicans and democrats and signed by ronald reagan. everyone supported it except the elderly. and once they found out they were going to be required to buy coverage that they didn't think they needed, they were furious. there was a famous scene in chicago where a bunch of old folks were chasing the chairman of the powerful ways and means committee, down the streets of chicago with their picket signs and cains. when he tried to escape in his car, they beat up his car with their canes. whenever everyone in washington agrees with something, you can pretty well be assured that it's wrong. because they're not talking to the american people. massachusetts passed mandatory coverage a couple years ago and bob blenden from harvard did a survey of the people directly afected by that mandate. the people directly affected by
the mandate, 22% of them said the law is helping them. 60% said the law is hurting them. so the very people that were going to pass this mandate because they're so concerned about, are telling us that it hurts more than it helps. in fact, the only reason in massachusetts that there hasn't been a revolt, i think, is because there aren't that many people in massachusetts affected by it. the rate of noninsurance in massachusetts before it was less than 10%. but if you look at california, the rate of noninsurance is 20% of the population in that state. in florida, it's 25%. in texas, it's 27%. these are the people that we're going to help? and once they find out how much washington is helping them, i don't think they're going to appreciate it very much. in fact, instead of dictating to these people, we should be listening to them. there's a reason that they're
not buying coverage. and it's not just affordability. 1/3 of the uninsured are already ill eligible for free medicaid. they found out once they enroll in a program, they still can't see a doctor because medicaid pays doctors so little that very few doctors will take it. so they roll down to the e.r. just like they did before they were on medicaid. so what's the point? why bother having coverage? why bother enrolling when nothing in your life changes? and in fact, for schip program, a third of the uninsured charne that are currently eligible for schip, had been enrolled in a program within the past 12 months. they know how to get enrolled, and they found it of so little value that they didn't bother reenrolling, their parents didn't. if we don't listen to folks,
and what they're telling us is that the cog that is out there is simply not attractive. they don't find value in it even when it's free. we should be listening to them and revising our insurance programs to suit that market instead of dictating to them. if we insist on dictating to them that they buy coverage that they don't value, we're basically telling working people, basically telling joe the plumber, that before he feeds his children, before he puts his gas this his car to get to work, he's got to pay for health insurance premiums, that that is the most important thing on earth, paying for your health insurance premiums. now, joe the plumber is not going to like that any more than the old folks that chased him down the streets of chicago. only joe the plumber carries a pipe wrench, not a cane. thank you. [applause] >> we have with us victor
schwartz, the chairman of the public policy group, an expert on medical malpractice reform. >> well, thank you all, and thank you, grover. grover asked me about bill clinton's health care plan. in one seasons, senior access to young nurses. so let me go to liability, which i probably just encountered. [laughter] reducing medical malpractice, at least in my judgment, really begins with the treatment stage. i think of doctor weiss who was my doctor, and he does certain things. when you have his staff, they treat you as a person, not push one or push two. and his waiting room is not a detention room. you actually get out of there at some point without losing
your whole day. he follows up with results. he can be reached in an emergency. and the truth is, the people who practice like dr. weiss are rarely seen. if there is government control of our medical system, dr. weiss won't be able to practice the way he's practicing, because all the things i mentioned will no longer have the flexibility that he has now and medical liability will increase. it will be a tinderbox and no one is looking at that aspect, because it is the freedom of the doctors to practice sound medicine. it is one of the big things that cuts malpractice, and that goes away once the government tells people how to practice medicine. civil justice reform is spoken about by the president about others and they talk about medical malpractice. i just shared this with all of you, particularly media here. torque law, which has been my life. i wrote the basic book.
it's like a child's kaleidoscope. you switch one part of it and the whole thing changes. if you limit liability for doctors and don't do the same thing for pharmaceuticals, all the liability shifts and the congress is not going to be ready to assist pharmaceutical companies that way the last time i looked. i think another key point is federalism. states have acted on medical liability. doctors' rates are fixed by states. ironically, something like product liability, country wide rates. it's not one state. if one state changes its medical liability laws, you can have reform and it's happened. in texas, since 2003, there's a 27% increase in specialized medicine while rates are down. in mississippi, since 2006, premium reduction increased competition. in california, and that's the big one, since 1976, they've had a cap on advantages for
pain and suffering. that's a long time ago. democratic controls, never changed it. why sth because their increase over the past 30 years is 1/3 of cost of liability of the entire nation. and people don't like to talk about it or look at it on the other side. so it actually works. there's no boxcars of people who are -- want lawsuits that are being thrown out of court. if there were, think california, that legislature would have changed that rule and they never have. there aren't really that strong of federal interests in liability, but there is one hook, and that's costs. and as cost has increased or taxpayer dollars are used, there is a federal interest in curving liability. the trial lawyers will tell you that, it doesn't make any difference. premiums are a small amount of total cost. but they leave out defensive medicine, which costs can be if the billions. they just leave that out. those costs need to be